Knowledge and Practice on Dental Avulsion Management Among General Dentists in Isfahan: A Cross-Sectional Study Knowledge and Practice on Dental Avulsion Management
Journal of Dental School,
Vol. 44 No. 1 (2026),
29 December 2025
,
Page e1
https://doi.org/10.22037/jds.v44i1.47563
Abstract
Objective(s): Dental avulsion is a serious dental trauma that requires timely and appropriate management to ensure favorable outcomes. The aim of the present study was to assess the knowledge and clinical practice of general dentists regarding dental avulsion management. Methods: A cross-sectional study was conducted in 2024 among 129 general dentists in Isfahan, Iran. A structured, researcher-designed questionnaire assessed knowledge (16 items), and practice (10 items) related to dental avulsion management, focusing on critical extra-alveolar time, optimal storage media, antibiotic prophylaxis, endodontic treatment timing, and availability of educational materials, based on international guidelines. Data were analyzed using Student’s t-test and Kruskal-Wallis test to evaluate the associations between knowledge and practice scores and demographic variables (gender and years of experience). Results: The mean knowledge and practice scores were 4.97 ± 1.26 and 5.39 ±1.61, respectively, indicating moderate levels. Regarding knowledge, most dentists correctly identified the critical extra-alveolar time, while less than half recognized the optimal storage medium and appropriate timing for revascularization in open apex teeth. Approximately one-fourth acknowledged the need for antibiotic prophylaxis, and mostly underestimated the adverse effects of storing avulsed teeth in tap water. In terms of practice, about 15% had educational materials on dental avulsion in their clinics, and over 90% expressed a need for further training. No significant associations were found between knowledge scores and gender (p= 0.42), or years of experience (p= 0.43). Similarly, practice scores were not significantly associated with gender (p=0.23), or years of experience (p=0.66). Conclusion: General dentists in Isfahan demonstrated moderate knowledge and clinical practice regarding dental avulsion management, with notable gaps in key areas such as storage media, antibiotic prophylaxis, and revascularization potential. These findings highlight the need for structured continuing education programs and the dissemination of clinical guidelines to improve the management of dental avulsions.
- Tooth Avulsion
- Dentists
- Clinical Competence
- Knowledge
- Professional Practice
How to Cite
References
1. Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, DiAngelis AJ, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dental Traumatology. 2012;28(2):88-96. doi: 10.1111/j.1600-9657.2012.01125.x
2. De Vasconcellos LGO, Brentel AS, Vanderlei AD, De Vasconcellos LMR, Valera MC, De Araújo MAM. Knowledge of general dentists in the current guidelines for emergency treatment of avulsed teeth and dental trauma prevention.Dent Traumatol. 2009;25(6):578-83.doi: 10.1111/j.1600-9657.2009.00820.x
3. Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, et al. Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth. Dent Traumatol. 2007;23(3):130-6. doi: 10.1111/j.1600-9657.2007.00605.x
4. Wang G, Wang C, Qin M. A retrospective study of survival of 196 replanted permanent teeth in children. Dental Traumatology. 2019;35(4-5):251-8. doi: 10.1111/edt.12475
5. Day PF, Flores MT, O'Connell AC, Abbott PV, Tsilingaridis G, Fouad AF, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dent Traumatol. 2020 Aug;36(4):343-359. doi: 10.1111/edt.12576
6. Andreasen J, Borum MK, Jacobsen HL, Andreasen FM. Replantation of 400 avulsed permanent incisors. 2. Factors related to pulpal healing. Endod Dent Traumatol. 1995;11(2):59-68.
doi: 10.1111/j.1600-9657.1995.tb00462.x
7. Bourguignon C, Cohenca N, Lauridsen E, Flores MT, O'Connell AC, Day PF, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol. 2020;36(4):314-30.
doi: 10.1111/edt.12578
8. Al-Sehaibany FS, Alajlan R, Almubarak D, Almaflehi N, Aljabaa A, AlBarakati SF. Knowledge on management of traumatic dental injuries among Saudi mothers. Clin Cosmet Investig Dent. 2018:10:123-8. doi: 10.2147/CCIDE.S167152
9. Razeghi S, Mohebbi SZ, Mehrtalab L, Fard MJK. Knowledge and practice of senior medical students in Tehran university of medical sciences toward emergency management of tooth avulsion. J Craniomaxillofac Res. 2018:105-11.
10. Buldur B, Kapdan A. Factors associated with knowledge and attitude of management of traumatic dental injuries: a cross-sectional study among Turkish dentists. Pesqui. bras. odontopediatria clín. integr. 2018;18(1).
11. AlJazairy YH, Halawany HS, AlMaflehi N, Alhussainan NS, Abraham NB, Jacob V. Knowledge about permanent tooth avulsion and its management among dentists in Riyadh, Saudi Arabia. BMC Oral Health. 2015;15(1):135. doi: 10.1186/s12903-015-0126-3
12. Ahmadi M, Seidkhani H, Tila A. Dentists' Awareness in Emergency Management of Traumatic Dental Injuries: Implications for Improved Care. J Dent Sch. 2025;43(2):47-51. doi: 10.22037/jds.v43i2.46617
13. Alnaggar D, Andersson L. Emergency management of traumatic dental injuries in 42 countries. Dent Traumatol. 2015;31(2):89-96. doi: 10.1111/edt.12155
14. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453-7. doi: 10.1016/S0140-6736(07)61602-X
15. Mazur M, Jedliński M, Janiszewska-Olszowska J, Ndokaj A, Ardan R, Nardi GM, et al. Knowledge of emergency management of avulsed teeth among Italian dentists-questionnaire study and next future perspectives. Int J Environ Res Public Health. 2021;18(2):706. doi: 10.3390/ijerph18020706.
16. Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, DiAngelis AJ, et al. Guidelines for the management of traumatic dental injuries: 2. avulsion of permanent teeth. Pediatr Dent. 2017;39(6):412-419. doi: 10.1111/j.1600-9657.2012.01125.x
17. Dong Y, Peng C-YJ. Principled missing data methods for researchers. SpringerPlus. 2013;2(1):222. doi: 10.1186/2193-1801-2-222
18. Chopra A, Lakhanpal M, Rao N, Gupta N, Vashisth S. Traumatic dental injuries among 12-15-year-old-school children in panchkula. Arch Trauma Res. 2014;3(1):e18127. doi: 10.5812/atr.18127
19. Levin L, Day PF, Hicks L, O'Connell A, Fouad AF, Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction. Dent Traumatol. 2020;36(4):309-13.
doi: 10.1111/edt.12574
20. Contaldo M, D’Ambrosio F, Ferraro GA, Di Stasio D, Di Palo MP, Serpico R, et al. Antibiotics in dentistry: A narrative review of the evidence beyond the myth. Int J Environ Res Public Health. 2023;20(11):6025.doi: 10.3390/ijerph20116025
21. Zafar K, Ghafoor R, Khan FR, Hameed MH. Awareness of dentists regarding immediate management of dental avulsion: Knowledge, attitude, and practice study. J Pak Med Assoc. 2018;68(4):595-9.
22. Seyfi N, Valizadeh M. Evaluation of general dentists’ knowledge regarding management of dental trauma. J DentMed. 2017;29(4):271-6. [Pershian]
23. Mustafa M. Awareness about management of tooth avulsion among general dental practitioners: a questionnaire based study. J Orthod Endod. 2017;3(1):2.doi: 10.21767/2469-2980.100036
- Abstract Viewed: 44 times
- PDF Downloaded: 38 times